Sex Differences in Outcomes of an Intensive Risk Factor Modification Program in Patients With Atrial Fibrillation.

IF 9.1 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation. Arrhythmia and electrophysiology Pub Date : 2024-07-01 Epub Date: 2024-06-18 DOI:10.1161/CIRCEP.123.012534

Jean Jacques Noubiap, Rajeev K Pathak, Gijo Thomas, Adrian D Elliott, Prashanthan Sanders, Melissa E Middeldorp

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引用次数: 0

Abstract

Background: The outcomes of atrial fibrillation (AF) seem to be variable between males and females. We therefore aimed to determine sex differences in weight loss, cardiorespiratory fitness gain, and recurrence and progression of AF following risk factor management.

Methods: Of 1415 consecutive patients referred for electrophysiology management of AF, 825 had a body mass index of ≥27 kg/m²; after exclusions, 355 (males, 234; females, 121) were offered risk factor management and participation in a tailored exercise program.

Results: Females were older than males (65.5±10.4 versus 62.5±10.6 years; P=0.013) with a higher body mass index (34.1±5.4 versus 32.6±4.1 kg/m²; P=0.003) and more commonly paroxysmal AF (67.8% versus 48.3%; P<0.001). There was no sex difference in clinic attendance (58.7% versus 60%; P=0.82), weight loss (P=0.86), fitness gain (P=0.44), or improvement in AF symptoms (P=0.35). Weight loss (≥10% compared with <10%) was associated with lower total AF recurrence in males (hazard ratio, 0.41 [95% CI, 0.23-0.73]) and females (hazard ratio, 0.41 [95% CI, 0.20-0.83]). Fitness gain (≥2 metabolic equivalents compared with <2 metabolic equivalents) was associated with lower total AF recurrence in females (hazard ratio, 0.13 [95% CI, 0.05-0.30]) but not in males (hazard ratio, 0.63 [95% CI, 0.38-1.04]; P=0.002). There was a trend toward more reversal from persistent to paroxysmal AF in males compared with females (21.8% versus 14.0%; P=0.079).

Conclusions: Males and females with AF demonstrate a similar degree of weight loss and fitness gain through structured risk factor management. However, fitness had a much greater benefit for total arrhythmia recurrence in females compared with males, whereas there was a trend toward more AF reversal in males.

Registration: URL: https://anzctr.org.au; Unique identifier: ACTRN12614001123639.

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心房颤动患者在强化危险因素调整项目中的结果性别差异。

背景：心房颤动（房颤）的治疗效果在男性和女性之间似乎存在差异。因此，我们旨在确定体重减轻、心肺功能增强以及风险因素控制后房颤复发和进展方面的性别差异：方法：在连续转诊的 1415 名房颤电生理学治疗患者中，有 825 人的体重指数≥27 kg/m2；在排除其他因素后，有 355 人（男性 234 人，女性 121 人）接受了风险因素管理并参加了量身定制的运动计划：女性比男性年龄大（65.5±10.4 岁对 62.5±10.6岁；P=0.013），体重指数高（34.1±5.4 kg/m2 对 32.6±4.1 kg/m2 ；P=0.003），更常见阵发性房颤（67.8% 对 48.3%；PP=0.82）、体重减轻（P=0.86）、体能增强（P=0.44）或房颤症状改善（P=0.35）。体重减轻（≥10%，P=0.002）。与女性相比，男性有更多从持续性房颤逆转为阵发性房颤的趋势（21.8% 对 14.0%；P=0.079）：结论：通过结构化的风险因素管理，男性和女性房颤患者的体重减轻和体能增强程度相似。然而，与男性相比，健身对女性心律失常总复发的益处更大，而男性则有更多房颤逆转的趋势：URL: https://anzctr.org.au; Unique identifier：ACTRN12614001123639。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Circulation. Arrhythmia and electrophysiology 医学-心血管系统

CiteScore

13.70

自引率

4.80%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Circulation: Arrhythmia and Electrophysiology is a journal dedicated to the study and application of clinical cardiac electrophysiology. It covers a wide range of topics including the diagnosis and treatment of cardiac arrhythmias, as well as research in this field. The journal accepts various types of studies, including observational research, clinical trials, epidemiological studies, and advancements in translational research.